Active NPI
Annalee Mendoza
- Technician
- Trabuco Canyon, CA
National Provider Identifier
1336707157
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Technician
- Practice address
- 20342 Flanagan Road
Trabuco Canyon, CA 92679 - Phone
- (818) 582-8832
- Fax
- (818) 582-8836
- NPI assigned
- Jun 5, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | |||
| Technician | 374700000X | Primary |
Addresses
Primary practice location
20342 Flanagan Road
Trabuco Canyon, CA 92679
Mailing address
84501 Guitron St
Coachella, CA 92236-1372
Phone (760) 989-0544
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635292800000",
"number": "1336707157",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "84501 GUITRON ST",
"city": "COACHELLA",
"state": "CA",
"postal_code": "922361372",
"telephone_number": "760-989-0544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20342 FLANAGAN ROAD",
"city": "TRABUCO CANYON",
"state": "CA",
"postal_code": "92679",
"telephone_number": "818-582-8832",
"fax_number": "818-582-8836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDOZA",
"first_name": "ANNALEE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-05",
"last_updated": "2021-10-27",
"certification_date": "2021-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": false
},
{
"code": "374700000X",
"taxonomy_group": "",
"desc": "Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trabuco Canyon, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.